title: Cardiovascular risk assessment in persons with HIV infection in the developing world: comparing three risk equations in a cohort of HIV-infected Thais.
abstract: OBJECTIVE
  There is growing concern regarding cardiovascular disease in HIV-infected individuals in developing countries such as Thailand. We evaluated the 10-year risk of coronary heart disease (CHD) in a Thai HIV-infected cohort using three cardiovascular risk equations, and assessed the level of agreement among their predictions.
  
  
  METHODS
  We carried out a cross-sectional analysis of data on 785 Thai subjects followed prospectively in the HIV Netherlands Australia Thailand Collaboration (HIV-NAT) cohort study from 1996 to 2009. Cardiovascular risk factor history, along with relevant laboratory and clinical data, was collected at follow-up clinic visits. Ten-year risks of CHD were calculated using the Framingham, Ramathibodi-Electricity Generating Authority of Thailand (Rama-EGAT) and Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) risk equations.
  
  
  RESULTS
  The mean age of the patients was 41.0 years; 55% of the subjects were male. The mean duration of antiretroviral therapy was 7.7 years. The prevalence of cardiovascular risk factors was low, with the most common risk factor being low high-density lipoprotein (HDL) (36.3%). The prevalence of high cardiovascular risk scores (defined as 10-year risk of CHD≥10%) was also low: 9.9, 2.1 and 0.8%, by the Framingham, Rama-EGAT and D:A:D scoring systems, respectively. Only eight subjects (1.0%) had a history of CHD. Bland-Altman plots showed that the Framingham equation predicted a higher risk of CVD compared with the Rama-EGAT and D:A:D equations, which agreed relatively well.
  
  
  CONCLUSIONS
  The predicted cardiovascular risk in this HIV-infected Thai cohort was relatively low. The agreement among the Rama-EGAT and D:A:D risk scores suggests that both equations may be appropriate estimators of cardiovascular risk in this population.
authors.affiliation: Columbia University College of Physicians & Surgeons, New York, USA.
authors.forename: N
authors.initials: N
authors.lastname: Edwards-Jackson
authors.forename: Sj
authors.initials: S
authors.lastname: Kerr
authors.forename: Hv
authors.initials: H
authors.lastname: Tieu
authors.forename: J
authors.initials: J
authors.lastname: Ananworanich
authors.forename: Sm
authors.initials: S
authors.lastname: Hammer
authors.forename: K
authors.initials: K
authors.lastname: Ruxrungtham
authors.forename: P
authors.initials: P
authors.lastname: Phanuphak
authors.forename: A
authors.initials: A
authors.lastname: Avihingsanon
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D001315:Australia; D002318:Cardiovascular Diseases / Q000209:etiology / Q000821:virology*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000209:etiology / Q000821:virology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D018570:Risk Assessment; D013785:Thailand